What Happens to the Pocket After Breast Implant Removal?

If the capsule is not taken out? Can you feel it? What happens to the pocket when breast implants are removed?

Doctor Answers 25

What happens to the breast pocket after implants are removed?

HI littleagain,

These are great questions.

In general, if you are having the implants removed and you have enough extra tissue left behind (ie, skin, breast and fat - nothing personal, of course) it may be advisable to have the capsule removed.  It may heal up well on its own but sometimes a smooth-walled pocket remains and it can continuously fill with fluid.  Removing at least part of the pocket (an anterior capsulectomy) will help the remaining tissue scar down and obliterate the space.  This is particularly true if the capsule itself is scarred, thickened, and/or calcified.

However, if you're very thin, then removing the capsule after the implant has been taken out may leave too little tissue there, and you'll be left with little but the excess skin.  In extreme cases, it can actually be risky to the blood supply of the remaining skin to remove that capsule.

In either event, the best final appearance with implant removal (assuming you're not going to reinsert implants) may be with a lift or some other procedure that can tighten the skin.  You don't really lose anything by just removing the implants and seeing how it heals, except that then you'd need a second procedure.  If it's clear enough at the outset that you'll need a lift, you may be able to get it over with at one procedure.

I hope that this helps, and good luck,

Dr. E

Removal of breast capsule after implant removal

Typically, I recommend removal of the capsule along with removal of the implant in order to prevent long-term fluid collection within this space.  Inevitably, there is some capsule formation in this breast pocket created with and around the implant.  In order to get the tissue to re-adhere and obliterate the potential space from where the pocket was previously, removal of the capsule (i.e., capsulectomy) is advised along with placement of a drain.  Once done, your breast should have the same appearance and feel and you should not be able to feel any difference.  Hope that these answers help!

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 17 reviews

The Capsule After Explantation

he body will absorb the capsule after the implants are removed.  This process is enhanced significantly if your surgeon removes parts of the capsule. Many surgeons use drains to prevent fluid (serum) from building up inside the empty capsule, which can slow absorption of the capsule.

Paul C. Zwiebel, MD
Denver Plastic Surgeon
4.5 out of 5 stars 27 reviews

Capsulectomy is often needed for complex revisional breast surgery

If you are having a simple implant removal procedure, the capsule should be excised and the 'pocket' obliterated, in order to prevent a long-term fluid collection from forming. This procedure is called a capsulectomy. I generally remove the anterior capsule only (in a sub-muscular argumentation) and then place a drain in the space for a few days. You cannot feel the remnants of the capsule when it is handled in this manner.

Pocket can collapse

If the pocket is not removed, then it can collapse and disappear, or it can fill with fluid and look like you still have an implant. Best suggestion is to remove the implant and capsule and suture the pocket closed while lifting the breast tissue as well.

Robert M. Freund, MD
New York Plastic Surgeon
5.0 out of 5 stars 27 reviews


Breast implant capsules vary. Plastic surgeon opinions vary as well regarding them. When capsules are left in place they can at times cause breast distortion or persistent fluid collections requiring more surgery. I take them out at least partially during implant removal surgery - particularly implant removals without replacement.

Best Regards.

John P. Di Saia, MD
Orange Plastic Surgeon
5.0 out of 5 stars 24 reviews

The implant pockets will most likely be gone with time

Breast implant pockets are reaction to a foreign body (your breast implant). Once the implant is removed, the pocket is usually resorbed and remodeled over time by your body. If there is a large pocket present and it is not closed at the time of surgery or a drain is not placed, there is a chance that a fluid collection will develop. This will either need to be drained or may resorb over time if it is small.

David Rankin, MD
Jupiter Plastic Surgeon
5.0 out of 5 stars 133 reviews

Implant removal

If the capsule is very thin, it can be left in place with no problems.  Capsules around the old gel implants should, if possible, be removed with the gel implant.  The old gel implants leaked, and gel would collect outside the implant.  Removing the capsule with the implant helped complete the removal of the gel. Capsules around saline implants or new gel implants may be left in place, especially if the capsule is thin and little breast tissue is present.  After the implants are removed, the pocket slowly shrinks, and usually the capusle is not felt.

Connie Hiers, MD
San Antonio Plastic Surgeon
4.5 out of 5 stars 12 reviews


The capsule after explantation does not dissolve.  It sometime shrinks somewhat but is there and can lead to infection, fluid collection, and problems with cancer detection.  If there is any biofilm in the scar capsule, this can lead to problems, and without total capsule removal, resolution of health issues, is much more difficult.

Susan Kolb, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

The pocket closes.

Once the implant is removed, the pocket collapses on itself and closes.  If there is a thickened, calcified capsule, it is usually removed with the implants dso that the scar tissue is not palpable.. 

Marisa Lawrence, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 31 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.